On the road to recovery from drug and alcohol addiction: How employment and relationships are key to success

Substance use disorders result in significant economic and healthcare burdens. Therapeutic communities are treatments used to aid in successful recovery. A recent study published in BMC Psychiatry suggests that the road to recovery is more than merely abstinence.

Our research team wanted to find which factors influence early withdrawal from a drug and alcohol treatment program. The question arose partially from another recent study we conducted that was published in Substance Abuse Treatment, Prevention, and Policy. This study found that residents that were satisfied with their relationships, when entering a rehabilitation program, were less likely to complete the program.

We presumed this reflected distress in response to separation from loved ones but felt that qualitative research was warranted to understand this better. We interviewed ex-residents from a long-term therapeutic community program at a community-based rehab organisation in regional Australia. In addition, we attempted to elucidate what successful recovery actually means to ex-residents and how employment influences early withdrawal and successful recovery.

Perceived successful recovery extends far beyond obtaining and remaining abstinent. Ex-residents believed that reduced substance use and continued treatment had a positive influence on recovery. Understanding that recovery is a journey is important when measuring success.

It is important for society, and not just those suffering from addiction, to recognize that shorter lapse periods and early trigger recognition are signs of success.

Ex-residents said that the residential rehab program helped them to be more aware of the early signs of addiction and halt the progression of the lapse before losing total control. Overall, ex-residents experienced shorter lapses and relapses by utilizing the skills they learned at the residential rehab program. It is important for society, and not just those suffering from addiction, to recognize that shorter lapse periods and early trigger recognition are signs of success.

Influence of Employment

Our study showed that employment influenced peoples’ drug addiction before, during and after their rehabilitation stay.

Prior to entering the program, many residents had difficulties finding or maintaining a job. For others, their work led them to using drugs for a variety of reasons including feeling lonely when working in remote areas, working in a high paced environment such as pubs and clubs, or having high-paying jobs thereby making substances affordable.

“I was extremely good at what I did and when I lost that trade, I lost myself pretty much. I put so much emphasis on my job. Once I lost it that was it.”

Some people left the program early because they felt they had to get back to work and were ready to leave. Our study found that being able to work, study or volunteer was a very important factor for a successful recovery as it increased self-worth and instilled feelings that ex-residents were contributing to society in a positive way. Similar results were found in a study from the UK .

“I really feel they’ve got a better employee back do you know what I mean? They may have lost me for 6 months but they’ve actually got a better employee.”

Influence of Relationships

“…the ability to be able to listen and be honest with myself … and be able to share other people’s stories and listen to them to be a support.”

Like employment, relationships were strong factors for both successful recovery and early departure from the program. For example, some could not cope with the intensity of the program while others missed their family and friends. Improved relationships with family, friends, co-workers and society in general were indicators of successful recovery. Relationship successes after leaving the program enabled ex-residents to form close relationships with new people, rebuild existing ones and help others in their recovery journey.

Success could also be measured when ex-residents were leading much healthier lives leading to improved psychological and physical wellbeing. Many would continue to practice skills such as yoga, meditation and physical exercise, which they learned during the program.

From a policy and treatment point of view this study shows the value of supporting residents to not only focus on abstinence but also identify how they can actively contribute to the community by studying, volunteering or finding employment.

Some people have returned to volunteer at rehabilitation programs, which can be a powerful message to those in the program that they can be successful in their recovery too. It is important that residents receive support and a safe environment to achieve a success recovery.

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Sabrina Pit: Dr Sabrina Pit is the Workforce Research Stream Leader and Lead Academic, Clinical and Educational Research focusing on work, health and ageing at the University Centre for Rural Health (University of Sydney and Western Sydney University). She has a strong interest in keeping people at work in a healthy and happy manner and developing a strong health system and workforce. She is currently a non-executive Director of Multitask Human Resource Foundation Pty Ltd and is a member of the International Standards Organisation Technical Committee Ageing Societies, Ageing Workforce.

Mrs. Tarran Prangley: Ms Prangley, is a final year medical student from Graduate Medicine at the University of Wollongong.

Dr. Jessica Nealon: Dr Jessica Nealon is a Lecturer in Medical Science at the School of Medicine, University of Wollongong. Jessica does research in systems biology, physiology and most recently, in qualitative implementation science

Mr. Trent Rees: Mr Trent Rees is the Residential Programs Manager at the Buttery, New South Wales Australia.